Provider Demographics
NPI:1215347943
Name:KALL ENTERPRISES LLC
Entity type:Organization
Organization Name:KALL ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LADC, CCJS
Authorized Official - Phone:405-209-1470
Mailing Address - Street 1:608 N RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-3852
Mailing Address - Country:US
Mailing Address - Phone:405-209-1470
Mailing Address - Fax:
Practice Address - Street 1:608 N RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-3852
Practice Address - Country:US
Practice Address - Phone:405-209-1470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1099251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health